| Scott M Jensen Dmd Pa | |
|
920 Cherry St Greensboro NC 27401-1422 | |
| (336) 379-1500 | |
| (336) 379-8585 |
| Full Name | Scott M Jensen Dmd Pa |
|---|---|
| Speciality | Dentist |
| Location | 920 Cherry St, Greensboro, North Carolina |
| Authorized Official Name and Position | Scott M Jensen (OWNER) |
| Authorized Official Contact | 3363791500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Scott M Jensen Dmd Pa 920 Cherry Street Greensboro NC 27401 Ph: (336) 379-1500 | Scott M Jensen Dmd Pa 920 Cherry St Greensboro NC 27401-1422 Ph: (336) 379-1500 |
| NPI Number | 1801101803 |
|---|---|
| Provider Enumeration Date | 08/13/2010 |
| Last Update Date | 06/27/2011 |
| Medicare PECOS PAC ID | 9335264308 |
|---|---|
| Medicare Enrollment ID | O20100914000779 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801101803 | NPI | - | NPPES |
| 2414647A | Other | NC | MEDICARE |
| 8994548 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 5555 (North Carolina) | Primary |
| Provider Name | Scott M Jensen |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1881770089 PECOS PAC ID: 3577523315 Enrollment ID: I20100915001268 |
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